You searched for:"Maria Célia Mendes"
We found (10) results for your search.Summary
Rev Bras Ginecol Obstet. 2020;42(1):1-4
Summary
Rev Bras Ginecol Obstet. 2010;32(4):156-162
DOI 10.1590/S0100-72032010000400002
PURPOSE: to analyze the differential diagnosis, follow-up and therapeutic approach in five cases of primary cardiac tumors diagnosed during the prenatal period. METHODS: during the period from January 1997 to December 2008, 7989 pregnant women were submitted to morphological ultrasound due to the presence of risk factors for fetal malformations. Fetuses with hyperechogenic intracardiac masses larger than 1 mm diagnosed by ultrasound evaluation of the fetal heart, were selected for study. The differential diagnosis between the different tumor types was made on the basis of the ultrasound characteristics of the masses. RESULTS: five fetuses with hiperechogenic intracardiac masses were diagnosed, corresponding to a 0.06% prevalence rate. Gestational age ranged from 28 to 36 weeks (mean: 31), and maternal age ranged from 23 to 45 years (mean: 34,2). The most frequent location of the masses was the left ventricle (100%). Echographically, all masses were single or multiple, hyperechogenic, homogeneous and well delimited, compatible with a diagnosis of rhabomyoma. In cases in which the diameters of the masses were less than 20 mm, an expectant conduct was followed and no complications occurred during the prenatal period. One case with a huge tumor presented arrhythmia and cardiac insufficiency during the 35 gestational weeks, and the interruption of pregnancy was indicated. Tuberous sclerosis was associated in four cases (80%) and the diagnosis was confirmed during the postnatal follow-up. CONCLUSIONS: fetal morphological ultrasonography is the main form of early detection of primary cardiac tumors. The fetal cardiac evaluation is of fundamental importance for the differential morphological characterization of cardiac masses and for the evaluation of cardiac function. Rhabdomyomas are the most common type of fetal tumor. An expectant pre and postnatal conduct is followed, with a low risk of complications and with the possibility of spontaneous regression in most cases. Postnatal clinical follow-up is mandatory due to the high frequency of associated tuberous sclerosis.
Summary
Rev Bras Ginecol Obstet. 2006;28(5):304-309
DOI 10.1590/S0100-72032006000500007
PURPOSE: to analyze the results of a screening and diagnostic program of arrhythmias and congenital heart disease in a reference hospital and the relevance of early diagnosis in the fetal and neonate evolution. METHODS: cardiac evaluation of 1159 fetuses was done in two different levels. Level I: by morphological ultrasound examination with the objective to detect the existence of either arrhythmias or structural cardiac malformations. Level II: by fetal echocardiography to establish the differential diagnosis. The results of level I in the arrhythmia group were compared with those of level II, and in the group with malformations the results of both levels were confronted with the neonate echocardiogram or necropsy. The kappa index was calculated to evaluate the concordance between the two levels. RESULTS: all detected arrhythmias in level I were confirmed in level II, there were no false negative cases and five patients with severe arrhythmia required pharmacological therapy. The diagnosis of structural malformation by level I had sensitivity of 72% and specificity of 98% and there were 28% of false-positive cases. In level II, the sensitivity and specificity of the diagnosis of congenital heart disease were 100 and 99%, respectively. The kappa index was 57% and indicated a moderate degree of concordance between the two levels. Fifty-one percent of the fetuses with diagnosis of cardiac malformations required pharmacological or invasive intervention immediately after birth. CONCLUSION: morphological ultrasound examination is a important tool in the screening of arrhythmias and congenital heart defects during fetal life. The sensitivity and specificity of the fetal echocardiogram were very high and the early diagnosis made it possible to treat the fetus with severe cardiac disease either during pregnancy or immediately after birth.
Summary
Rev Bras Ginecol Obstet. 2022;44(3):319-324
Summary
Summary
Rev Bras Ginecol Obstet. 2005;27(9):529-533
DOI 10.1590/S0100-72032005000900005
PURPOSE: to study the histological modifications that occur in the endometrium of women before and six months after tubal ligation (TL) and to correlate these findings with progesterone (P4) levels. METHODS: the study was conducted on 16 women with normal menstrual cycles who were evaluated before and in the sixth cycle after TL. P4 levels were determined from the 8th day at 2-day intervals until ovulation and on the 8th, 10th and 12th day after ovulation or on the 24th day of the cycle. An endometrial biopsy was obtained between the 10th and 12th day after ovulation or on the 24th day of the cycle and a correlation with P4 was determined. Data were analyzed statistically by the nonparametric McNemar test for the evaluation of hormonal determination and by the exact Fisher test for the histological evaluation of the endometrium, with the level of significance set at p<0.05. RESULTS: mean age was 34.1±1.3 years. The intermenstrual interval was 27.1±2.6 days and the duration of bleeding was 3 to 5 days, with no difference between the studied periods. Before TL, 8/16 (50.0%) of the cases had a secretory endometrium according to the cycle, 3/16 (18.8%) had a secretory endometrium not according to the cycle and 3/16 (18.8%) had a dysfunctional endometrium, suggesting a defect in the luteal phase in 6/16 (37.5%). After TL, 7/16 (43.8%) had a secretory endometrium according to the cycle, 3/16 (18.8%) a secretory endometrium not according to the cycle and 4/16 (25.0%) had a dysfunctional endometrium, suggesting a defect in the luteal phase in 7/16 (43.8%). In 2/16 (12.5%) of the cases before TL and in 2/16 (12.5%) other cases after TL it was not possible to perform histological evaluation due to insufficient material or unspecfiic endometritis. In the luteal phase after TL, mean P4 levels were significantly lower on days +8, +10 and +12 than before TL, being 15.1, 18.0 and 20.7 ng/ml, respectively, before TL and 10.6, 8.0 and 5.4 ng/ml after TL (p<0.05). Before TL, 5/8 (62.5%) of the cases with a secretory endometrium according to the cycle had P4 >10 ng/ml and 3/8 (37.5%) had P4 <10 ng/ml. After TL, when the endometrium was secretory according to the cycle, P4 was >10 ng/ml in 4/7 (57.1%) and <10 ng/ml in 3/7 (42.9%). These differences were nonsignificant (p>0.05). CONCLUSION: six months after TL, the intermenstrual interval and the duration of bleeding were unchanged. P4 levels decreased during the luteal phase although this did not interfere in the endometrial response.
Summary
Rev Bras Ginecol Obstet. 2022;44(5):548-556
Summary
Rev Bras Ginecol Obstet. 2002;24(9):609-614
DOI 10.1590/S0100-72032002000900007
Purpose: the objective of the present study was to determine the number and type of deliveries, category of admission to the hospital, occupation and obstetrical diagnosis for adolescents from the municipality of Ribeirão Preto, from January 1992 to December 1996. Methods: the information obtained from hospital discharge forms was analyzed at the Hospital Data Processing Center. The 6.04a-text processor Epi-Info System, a data bank and statistics for epidemiology produced by the Centers of Disease Control and Prevention (Atlanta, GA, USA), and Dbase IV were used to process the information. The association between variables was tested by the chi² test, with the level of significance set at 5%. The analyzed parameters were: number and type of delivery, category of hospital admission, occupation and obstetric diagnosis. Results: a total of 42,969 deliveries occurred during the study period, among which 7,134 (16.6%) corresponded to adolescent deliveries. An increase in the number of deliveries by girls in this age range occurred over the years, from 1,225 in 1992 to 1,538 in 1996. Deliveries were reported starting from 12 years of age, with a gradual increase in this number, especially after 14 years of age, when a 104.2% increase occurred for deliveries at this age, followed by 48.8% at 15 years, 36.1% at 16 years, 14.0% at 17 years, 52.8% at 18 years, and with practically no increase among 19-year-old girls. The highest number of deliveries (5,709) was recorded for the unified health system category of admission, followed by 1,277 deliveries for the prepaid category and 148 deliveries for the private category. With respect to occupation, 14.1% of the patients belonged to the economically active population, while 85.8% did not. Of the total deliveries, 59.2% were normal, 5.6% were forceps deliveries, and 35.2% were cesarean sections. The most frequent obstetrical diagnoses were: problems of fetus or placenta affecting maternal management (7.9%), fetus-pelvis disproportion (6.0%), problems with the amniotic cavity and membranes (5.0%), hypertension complicating delivery and puerperium (3.5%), and premature or false labor (3.4%). Conclusions: most deliveries were normal and occurred more frequently at the end of adolescence, especially among girls belonging to the unified health system. There was a predominance of adolescents not belonging to the economically active population. Some obstetrical complications were diagnosed at the time of resolution of pregnancy.